MARGARET Roberts' letter (June 26) advocating more Welsh in hospitals overlooks the obvious fact that all Welsh speakers understand, speak and use English on a voluntary basis every day, to use the internet, watch TV, to read a newspaper, in business, in tourism, to go abroad or into English speaking areas of the UK, or even to socialise with English-speaking colleagues or friends.

Many of these migrants are multilinguals who among their languages use English as a lingua franca (ELF), thereby decentering the English language from what Kachru (1992) has referred to as the traditional "inner circle" English-speaking countries: Canada, the United States, the United Kingdom, Australia, and New Zealand.

advertising campaigns for etanercept (Enbrel) and mometasone (Nasonex)--to which English-speaking Canadians were exposed through broadcast, print, and online media-did not cause a statistically significant change in prescribing patterns in English-speaking areas, when compared with French-speaking areas of Canada, where exposure was limited (BMJ 2008;337:al055 [doi:10.

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